Revenue Integrity Analyst

Community Health System Franklin , TN 37064

Posted 2 months ago

Summary: Responsible for analyzing, developing and establishing charge processes and procedures throughout the organization to maintain charge integrity in compliance with CMS and other regulatory agencies.

Responsible for maintaining current knowledge of the various regulatory agency guidelines and assure requirements are met along with accurate, complete and timely charge processes. This position will work throughout the organization nationally and with all types of departments and varying systems (i.e. Medhost, Cerner) and other systems to assure accurate charge processes.

Responsible for auditing current charge processes and, as needed, identifying correct charge processes. In addition, this position will need to develop staff training materials to assure accurate charge processes are implemented and maintained.

Essential Duties and Responsibilities:

1.Performs financial chart audits and document reports and findings along with recommendations and action plans for improvement. Implements and tracks action plans needed to assure for compliance of CHS standard charge capture practices

2.Assist clinical staff with updating, implementing and training staff to perform new charge processes

3.Works with vendors to research and validate charge capture opportunities and identify solutions; develops training to improve charge capture

4.Develops charge reconciliation processes to assure all charges are entered for patients treated for clinical departments; educates clinical staff on charge capture process and perform audits to assure compliance with charge reconciliation processes

5.Works closely with the CHS charge master team on charging policy and procedures, education to the facilities and appropriate revenue by department.

6.Provides support to all facilities on charge questions, training and education and charge reconciliation and capture.

7.Works with the CHS divisions on any charge, revenue issues or concerns related to charge audits including investigating and resolving root cause issues.

8.Captures and reports findings in on Excel spreadsheets or Access databases

9.Provides feedback and assist during the corrective action process.



  1. Drafts monthly summary for CHS Leadership

  2. Daily reports of findings, issues, resolutions, etc. for hospital leadership


Qualifications:

Preferred Education: Bachelor's degree in business, healthcare or related field preferred

Required Experience: Three (3) to five (5) years of Revenue Cycle experience

Required License/Registration/Certification: RHIA, CCS-P and/or CPC certification

Physical Demands:

In order to successfully perform this job, with or without a reasonable accommodation, the following are outlined below:

The Employee is required to read, review, prepare and analyze written data and figures, using a pc or similar and should possess visual acuity.

The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.

The Employee is not substantially exposed to adverse environmental conditions and therefore job functions are typically performed under conditions such as those found in general office or administrative work.



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Revenue Integrity Analyst

Community Health System